Issue link: https://www.massageandbodyworkdigital.com/i/72098
FIBROMYALGIA'S MYSTERIES Step-by-Step Protocol for Addressing Fibromyalgia helping the client breathe more efficiently, and stretching stiff limbs. HOW TO TREAT A FMS CLIENT If you bring to mind your last bout of the flu, you will have some idea of the energy-sapping state your FMS client deals with each day. The pain, tenderness, and fatigue are unrelenting—and yet many of the suggested therapeutic modalities demand that she move her body when all she wants to do is lay on the couch. Your deep compassion must be combined with your responsibility to get her moving again. The pain- spasm-pain cycle must be stopped, and circulation must be increased. Thorough charting is essential for mapping progressions and digressions. Deep-breathing exercises are critical for maintaining thoracic capacity and preventing pneumonia and other infectious diseases. Pretreatment heat, or rotating the presence of a hot pack around the body during the session, can provide great comfort and prepare an area for treatment. (Cold is typically not applied to FMS sufferers.) Soothing, light-to-moderate pressure (you will rarely apply deep pressure) will help gain the client's trust while easing her into a parasympathetic state and increasing circulation. Over my years of working with fibromyalgia clients, I've developed a protocol suitable for the many levels of pain with which they present. For brevity's sake, the protocol described here focuses on two bilateral points of tenderness (although it can be applied to all of the client's tender points), as well as deep-breathing exercises, stretching, and ROM techniques. Once the recipe has been tried and tested, seasoned therapists will most likely adapt the protocol to meet their and their clients' needs. 1 Start with the client supine; ask her to inhale deeply, hold for a few seconds, then forcibly exhale. Repeat 3 times (1 minute). 2 Using your whole hand, apply compression strokes (light pressure) to the entire anterior surface of the body, including the head and neck (2 minutes). 3 Taking one of the client's arms and cradling it securely with both of your hands, facilitate gentle stretching and ROM. Work slowly and rhythmically. Repeat at the shoulder joint, elbow joint, and wrist joint. Ask the client to clench and open her fist several times. Attempt to stimulate and engage every muscle and joint of the upper extremity. Repeat on the other arm (4 minutes each side, 8 minutes total). 4 Taking one of the client's legs and cradling it securely with both of your arms, facilitate gentle stretching and ROM. Work slowly and rhythmically. Repeat at the hip joint, knee joint, and ankle joint. Ask the client to tightly curl and uncurl her toes several times. Attempt to stimulate and engage every muscle and joint of the lower extremity. Repeat on the other leg (5 minutes each side, 10 minutes total). 38 massage & bodywork september/october 2011